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Sleep Apnea and Tongue Scalloping: A Simple Screening Test?

One of the most common exam findings that I see in people with sleep apnea is what’s called tongue scalloping. This is where you see ridges, or a scalloping pattern along with sides of the tongue, created by the tongue pressing against the side teeth. One study showed that having tongue scalloping was 70% predictive of the presence of obstructive sleep apnea.

Why does tongue scalloping occur? Multiple obstructions cause repeated vacuum pressures in the throat which suctions up your normal stomach juices, which includes acid, bile, enzymes and bacteria. These materials cause inflammation and swelling of the mucous membranes, narrowing the throat even further, causing even more obstruction. The tongue also swells slightly and because sleep apnea patients have small jaws by definition, the teeth press into the sides of the tongue, leaving indentation marks.

If you combine this finding with a small mouth and dental crowding, along with a tongue that sits very high (which prevents you from seeing the back of the throat), you’ll have a very high likelihood of having sleep apnea.

Take a look in the mirror right now. Do you have tongue scalloping? Please post your answers in the comment box below.

I too have tongue scalloping. I’ve often wondered why, when few of the people I know seem to have it. I have also had two sleep studies done over the last decade, and have been diagnosed with moderate OSA.

I noticed this problem with my tongue years before I was diagnosed with sleep apnea. I knew it mean something was wrong and in fact I had associated it with my sleep. On nights where I felt worse the next day the scalloping seemed worse. I brought this up with several doctors who all thought I was nuts to think there was some connection between my sleep and my tongue… I’m glad to find out years later that in fact there was a connection and logical explanation.

Is there a suggested remedy for scalloped tongue? I’ve had these scallops for years and have recently begun CPAP use for sleep apnea. (My Chinese acupuncturist has told me that in traditional Chinese medicine, the scalloped tongue is related to stomach/digestion issues, so that would seem to agree with comments here. Every I go for treatment, he checks my tongue, so I’m watching with great interest to see whether this changes over the next 8 treatments I’ve committed to to focus on stomach/digestive issues which are certainly very mild to my perception but apparently the deficiency in my stomach function is pronounced according to Chinese pulse diagnosis.

I’m wondering what remedy is suggested, if any, for the swollen tongue. I’ve seen the remarks about cause and have stopped eating late at night. Any other suggestions? Yes, I also have a small “jaw” space. I’ve just always said I have a small mouth, an opinion I arrived at after having bridgework done and wondering how the dentist could work in such a small space.. I’m interested in comments here or from reader comments. Thanks!

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About Dr. Park

Dr. Steven Y. Park is an author and surgeon who helps people who are always sick or tired to once again reclaim their health and energy. For the past 13 years in private practice and 4 years in academia, he has helped thousands of men and women breathe better, sleep better, and live more fulfilling lives.

The material on this website is for educational and informational purposes only and is not and should not be relied upon or construed as medical, surgical, psychological, or nutritional advice. Please consult your doctor before making any changes to your medical regimen, exercise or diet program. Some links may go to products on Amazon.com, for which Jodev Press is an associate member.